The patient came to the clinic 16-July-2002 complaining of LBP for 18 years with bilateral sciatica, more the right with inability to walk more than 50 meters due to intermittent claudication. The condition is progressing. She is diabetic for 15 years and hypertensive for 10 years

On examination: The patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS 70 degrees both sides with pain. There is weal dorsi and planterflexion both feeet-4/5.

The patient was sent for investigation: MRI lumbar spine performed 19-July-2002 showing severe lumbar canal stenosis L3-4 and L4-5.

Decompressive laminectomy L3, L4, upper third of L5. Foraminotomy both L4 and L5 roots both sides. Inspection both disci revealed that the L3-4 is causing compression at the right L4 root, for what discectomy L3-4 was performed and bilateral cleaning starting from the right side of L3-4 was achieved. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.

Smooth postoperative recovery. The power of both feet improved. She was sent to the ward.

The patient came to the clinic 03-August-2002 with clean wound and the power of the feet improved.

The patient came to the clinic 03-September-2002 still having the same scoliotic stance. She was treated conservatively.

The patient then came 13-October-2013, telling that the last 5 years had LBP with right sciatica for 1 year. Using crutch for 1 year. She had Bell's palsy 1 year ago. Cath was done 7 years ago and stinting was applied. MRI lumbar spine performed 05-October-2013 showing discitis of L2-3, spondylolisthesis L4-5 with right foraminal occlusion. There is hypalgesia both legs below the knees with weak dorsi and planterflexion both feet 3/5. She was advised to be admitted to the hospital for treatment of infection and she went to KHMC.

The sooner the surgical decompression, the better the outcome.

The patient over the years will suffer from other condition not related for his surgery.